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1
Q

bohr equation

A

Vd/Vt = (PACO2- PECO)/PACO2 ||| PECO2 is mixed expired CO2

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2
Q

alveolar air eq

A

PAO2 = (Pb-PH2O)(FiO2)-(PaCO2/.8)

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3
Q

blood o2 content

A

PaO2.0031+1.34hgb*O2sat

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4
Q

mixed defect

A

TLC < 80% and FEV1/FVC < 80%

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5
Q

why dyspnea in COPD?

A

hyperinflation
loss of elasticity
hypoxia, hypercapnia (more in CB)
airway obstruction

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6
Q

why airway obstruction in COPD?

A

loss of airway tethering
effect of active expiration on airways
bronchiolostenosis
in CB, airway inflammation and secretions

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7
Q

why COPD hypercapnic

A

late in dz, mostly CB
high WOB
decreased sensitivity to CO2
V/Q mismatch

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8
Q

causes of resp alkalosis

A

fever, pain anxiety
hypoxia
preg, liver dz, asa

2/5 Hco3 for every 10 pco2

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9
Q

cuase of resp acidosis

A

drugs (opiates, benzos)
severe lugn dz (COPD)
NM, chest wall dz

1/3.5 hco3 for 10 pco2

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10
Q

shunt

A

low v/q
ventilation increased to nearby segments
hypoxic vasoconstriction
predominantly hypoxia

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11
Q

dead space

A

infinity v/q
ventilation to dz segment wasted
perfusion to nearby segments increased

hypercapnia!!

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12
Q

what causes increase aa gradient

A

diffusion impairment
shunt
net hypoventilation
v/q mismatch

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13
Q

rising paco2 with 02 in chronic resp failure

A

hypoventilation b/c loss of hypoxic drive
worsening v/q
haldane effect

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14
Q

emphysema tx

A

anti-cholinergic +/- SABA
LABA, inhaled ster, theo
O2!
Pulm rehav, surgery

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15
Q

tx for flares of emphysems

A

antibx, IV steroids

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16
Q

asthma tx

A

SABA & inhaled steroid
LABA, LT antagonist

17
Q

tx for asthma flare

A

systemic steroid, O2 for flares (no antibx)

18
Q

most common CAP pathogens

A

mycoplasma (ambulatory)
strep, pneumo - wards & ICU & ambulatory!
legionella - ICU
resp virsus - ambulatory and wards - more common in kids
chlamydai pneumoniae - ambulatory

19
Q

staph aureua

A

causes pneumo in very sick patients, post-flu!!!, MRSA

20
Q

consolidation physical findings

A

palpation - increased fremitus
auscultatory findings: bronchial (tubular) sounds
rales/crackles
egophony
whispered pectoriloquy

21
Q

List the common causes of a transudative pleural effusion

A

CHARM

Carditis/Cardiac failure
Hypothyroidism
Albuminemia (hypo)
Renal failure
Meig’s syndrome/Malabsorption

22
Q

List some causes of an exudative pleural effusion

A

PINTARS

Pneumonia (pancreatitis
Infarction
Neoplasm
Tuberculosis/Trauma
Abscess
Rheumatoid arthritis
Sarcoidosis/SLE/Scleroderma

23
Q

what causes low glucose pleural effusion

A

TB, RA, infection

24
Q

how to identifiy empyema

A

very high WBC

25
Q

what causes bloody pleural effusion

A

trauma, asbestos

26
Q

hwo to identify incipient infection for pleural effusion

A

low PH

27
Q

how to identify complicated parapneymonic

A

high LDH

28
Q

what causes chylous (high TG) pleural effusion

A

lymphoma, trauma

29
Q

causes of diffuse intersitital lung disease

A

IPF with UIP - lower
CVD (scleroderma) - lower
drugs (amiodarone, bleomycin)
sarcoidosis - upper.middle
hypersensitivity - upper
lympangitic spread

30
Q

neuromuscular dz pfts

A

restrictive (<80% TLC) but preserved RV
normal (when corrected) Dlco,

smare in obestiy and poor effort

31
Q

hemodynamic effects of mv

A

decreased CO due to
loss of negatvie IPP
descreased venous return
compression of pulm capillaries
sptal shift

tx with fluid, inotropes

32
Q

causes of diffuse alveolar infiltrates

A

CHF
ARDS
diffuse pneumo - pcp
aspiration
dah
tumor - adenocarcinoma in situ

33
Q

lung cancer summary

A

small cell: 15%, no subtypes, central, localized or disseminated staging, chemo or chemo + rad, rarely curable, usally responds & recurs
non-small cell: 85%, adeno, squamous, large cell, central or peripheral, tnm, surgery, rad for pall, curable depending on stage

34
Q

PEEP effects

A

recruits atelectatic alveoli, improves FRC, improves hypoxemia from shunt-like effect of alveolar filling

35
Q

monitoring patients on mech vent

A

clinical - secretions, mental status, cxr, underlying process
gas exchnage - po2, pco2
mechanis - cstat

36
Q

if ppeak-pplat is same

A

parenchymal problems:
pulm edema
pulem embolus
pneumo
ptx
anxiety, pain
auto-peep

37
Q

if ppeak - pplat is bigger

A

ETT problems,
tubing kinked
secretions
bronchospasm

38
Q

tx for obesity hypoventilation syndrome

A

wt loss, bipap, trach, bariatric surgery

39
Q

how to diagnose osa vs ohs

A

both with psg (high ahi)
ohs –> daytime hypercapnia

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